Oral manifestation of sarcoidosis: A case report and review of the literature

Abstract

Sarcoidosis is a common multisystemic granulomatous disease characterized by the formation of nonnecrotizing epithelioid granulomas in various body organs. The most commonly affected organs in the head-and-neck region include salivary glands and cervical lymph nodes. Involvement of the oral mucosa is very rare. The purpose of this report is to present an atypical oral manifestation of sarcoidosis with ulcerations of the buccal mucosa in a 59-year-old female.

Oral sarcoidosis aiding in diagnosis of underlying systemic disease

“…Though the first case of sarcoidosis was reported by Jonathan Hutchinson in 1869, however, the term sarcoidosis was introduced by Boeck in 1899 which means ‘flesh-like condition’ in Greek. The first description of oral sarcoidosis was reported by Schroff in 1942 and Poe published the first histologically confirmed case involving mandible in 1943 1 2…”

“…The presence of a nodular granulomatous growth in oral mucosa narrowed our differential diagnosis to granulomatous conditions, such as TB, sarcoidosis, leprosy, fungal infections, Crohn’s disease, foreign body granulomas and granulomatosis with polyangiitis (Wegener’s granulomatosis) 1–3 6 9…”

“…Sarcoidosis is a chronic, multisystemic, granulomatous disease of unknown aetiology characterised by the formation of non-caseating granulomas 1–9. Its occurrence varies globally depending on the geographic location and ethnic distribution.…”

“…Females are slightly more affected than males. It shows bimodal age distribution, involving young adults and elderly 1–3 6–9. Lungs, skin, eye and liver are commonly involved.…”

“…Fatigue, malaise, non-productive cough, breathlessness, arthralgia and erythema nodosum are the common presenting features 1 2 4 5 9. Though head and neck involvement is seen in 10%–15% of the patients,3 oral sarcoidosis is uncommon 1 2. Usually, oral manifestations are seen in cases of systemic sarcoidosis.…”